Association of 25-hydroxyvitamin D levels with liver dysfunction and mortality in chronic liver disease.

Liver Int. 2012 May;32(5):845-51.
Putz-Bankuti C, Pilz S, Stojakovic T, Scharnagl H, Pieber TR, Trauner M, Obermayer-Pietsch B, Stauber RE.
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz,, Graz, Austria.

BACKGROUND:
Previous studies suggest that chronic liver disease may be related to vitamin D deficiency. It is, however, not known whether 25(OH)D levels are associated with incident hepatic decompensation and mortality in chronic liver failure.

AIMS:
We aimed to evaluate whether 25(OH)D serum levels are associated with Child-Pugh (CP) score, model for end-stage liver disease (MELD) score, occurrence of hepatic decompensation, and survival in patients with cirrhosis.

METHODS:
We enrolled 75 consecutive cirrhotic patients admitted to our outpatient liver clinic (32% females; age: 58 ± 11 years; aetiology alcohol in 61%). At baseline, 25(OH)D was determined and the degree of liver dysfunction was estimated by CP and MELD score. Thereafter patients were followed-up with respect to hepatic decompensation and mortality.

RESULTS:
25(OH)D levels averaged 16.0 ± 9.2 ng/ml and were inversely correlated with MELD score (r = -0.34, P = 0.003) and CP score (r = -0.21, P = 0.080).

Thirty-seven patients developed hepatic decompensation and 24 patients died during a median follow-up of 3.6 years.

Age- and gender-adjusted relative risk (with 95% confidence interval) was 6.37 (1.75-23.2; P = 0.005) for hepatic decompensation and 4.31 (1.38-13.5; P = 0.012) for mortality within the first vs the third 25(OH)D tertile but these associations were largely attenuated towards non-significant trends after additional adjustments for CP or MELD score.

CONCLUSIONS:
Our findings show a significant association of 25(OH)D with the degree of liver dysfunction and suggest that low 25(OH)D levels may predict hepatic decompensation and mortality in patients with chronic liver failure.

© 2012 John Wiley & Sons A/S. PMID: 22222013
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